While there are many possible reasons people lose hair, androgenetic alopecia or male pattern baldness is responsible for the vast majority of hair loss in men. This is a hereditary condition, with contributing genes being passed down from both maternal and paternal sides. There is often an immediate family history of hair loss in close family members. However, because there are several genes that are involved, there are also many different combinations that can be inherited. The trait can even skip expression between generations, such that family history does not always reflect the degree of hair loss a person might experience, nor whether for sure they will experience hair loss at all.
What is inherited in male pattern baldness sufferers, are patterned areas where the hair follicles have a genetic sensitivity to dihydrotestosterone (DHT). DHT is the predominate form of testosterone in the developing fetus. Following birth, testosterone becomes the primary male hormone. While DHT is critical for normal male fetal development, it can be thought of as largely unecessary leftover in later life. In fact, it seems to cause more trouble than good! It first affects the hair causing hair loss issues. Later in life, it appears to be a major contributing factor in the very common male condition called BPH; benign prostatic hypertrophy. There are even indications that DHT plays a role in the development of prostate cancer. Everyone has a certain amount of the hormone DHT. However, men with male pattern hair loss have a sensitivity to DHT that is not found in those without hair loss, nor in areas of the scalp where hair loss is absent. DHT interacts with the hair follicles in a way that disturbs the normal growth and rest cycle times.
Normally a hair follicle might have a 4-6 year growth (anogen) phase, followed by a brief resting (telogen) phase, during which the old hair shaft is shed in preparation for a new one to grow back in a replenishing process. Because of this cycling of normal hair growth, everyone might shed as many as 80-150 hairs per day. As long as an equivalent weight or mass of hair is also grown each day, there is no net hair loss or noticeable cosmetic changes. Hair follicles that continue to allow DHT to govern the normal growth and resting cycles of the hair are subject to eventual miniaturization. Miniaturization is easy to see on a video microscope, and is present in anyone having androgentic alopecia. Miniaturization results from a shortening of the normal growth phase time. Eventually, the growth phase time becomes so short, that the hair shafts don't even have time to come up to size, caliber, or pigmentation, before they are shed and the next cycle begins again. It's almost as though the hair follicles are being returned to the "baby hair" state.
This becomes established as a long-term disturbance in the normal adult growth/rest cycling and replenishment process, and eventually hair growth ceases entirely in the genetically sensitive areas. This then determines the pattern and degree of hair loss that a person might suffer over time. It's important to understand that the process of miniaturization, proceeding on to eventual baldness, can in most cases be slowed, stopped, and even partially reversed towards normal. This primarily involves the use of daily maintenance therapy. In men, this can be as simple as taking an inexpensive and very effective DHT blocking medication. Unfortunately, many men have received or read information that is scientifically false or misleading about the safety and side effect profile of these agents. This often results in ongoing hair loss that could have been entirely avoided safely and inexpensively. If you have been given this impression by information you have read, you owe it to yourself to get the clear facts and the big picture about the benefits and risks of medical interventions to stop hair loss and maintain healthy hair growth cycles.
For many if not most men, the risks of NOT using interventional therapy is even greater in terms of the image and confidence issues that the hair loss itself causes! Hair loss never really stops as an ongoing process without intervention. Usually it is such a slow and insidious process, that it goes unnoticed, or at least untreated, until it has become more advanced. By this time, hair transplantation has likely become the only effective method of re-establishing a hairline, and cosmetically correcting the problem. Fortunately for most, hair transplantation combined with preventive maintenance therapy, is also the best overall treatment approach to hair loss. Best of all, it is the all-natural treatment because it is real, growing hair that is your own!